{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:06:34Z","timestamp":1767773194155,"version":"3.40.5"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T00:00:00Z","timestamp":1596672000000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Abnormal dynamics of QT intervals in response to sympathetic nervous system stimulation are used to diagnose long\u2010QT syndrome (LQTS). We hypothesized that parasympathetic stimulation with cold\u2010water face immersion following exercise would influence QT dynamics in patients with LQTS type 3 (LQT3).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Study participants (<jats:italic>n<\/jats:italic>\u00a0=\u00a042; mean age\u00a0=\u00a011.2\u00a0years) comprised 20 genotyped LQTS children and 22 healthy children. The LQTS group was divided into LQT3 (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) and non\u2010LQT3 (<jats:italic>n<\/jats:italic>\u00a0=\u00a08) subgroups. Provocative testing for assessing QT dynamics comprised a treadmill exercise followed by cold\u2010water face immersion. The QT intervals were automatically measured at rest and during exercise, recovery, and cold\u2010water face immersion. The QT\/heart rate (HR) relationship was visualized by plotting beat\u2010to\u2010beat confluence of the data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The QT\/HR slopes, determined by linear regression analysis, were steeper in the LQTS group than in the control group during exercise and immersion tests: \u22122.16\u00a0\u00b1\u00a00.63 versus \u22121.21\u00a0\u00b1\u00a00.28, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001, and \u22122.02\u00a0\u00b1\u00a00.76 vs \u22120.75\u00a0\u00b1\u00a00.24, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001, respectively. The LQT3 patients had steeper slopes in the immersion test than did non\u2010LQT3 and control individuals: \u22122.42\u00a0\u00b1\u00a00.52 vs \u22121.40\u00a0\u00b1\u00a00.65, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001, and vs \u22120.75\u00a0\u00b1\u00a00.24, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The QT dynamics of LQT3 patients differ from those of other LQTS subtypes during the post\u2010exercise cold\u2010water face immersion test in this study. Abnormal QT dynamics during the parasympathetic provocative test are concordant with the fact that cardiac events occur when HRs are lower or during sleep in LQT3 patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.14319","type":"journal-article","created":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T07:51:34Z","timestamp":1590393094000},"page":"899-906","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Dynamic QT response to cold\u2010water face immersion in long\u2010QT syndrome type 3"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1964-9219","authenticated-orcid":false,"given":"Kazuhiro","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Pediatric Cardiology Okinawa Nanbu and Children\u2019s Medical Center Okinawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wataru","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Division of Cardiology Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomasa","family":"Makita","sequence":"additional","affiliation":[{"name":"National Cerebral and Cardiovascular Center Research Institute Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mami","family":"Nakayashiro","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology Okinawa Nanbu and Children\u2019s Medical Center Okinawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.84.3.1136"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2005.01.020"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.863209"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-14-0905"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.033943"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-6196(11)62209-X"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02850-4"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00255-7"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000048142.85076.A2"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.028258"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00582-3"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.600445"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq184"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.116.004400"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2006.05.013"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2011.05.018"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.1009"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2004.04.021"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.12734"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-016-1360-4"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-13-1516"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.2.782"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.062182"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)00131-9"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.1.89"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2012.04.007"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2018.04.033"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.70.773"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2014.271858"},{"key":"e_1_2_10_31_1","first-page":"H132","article-title":"Modulation of cardiac autonomic activity during and immediately after exercise","volume":"256","author":"Arai Y","year":"1989","journal-title":"Am. 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